Migraine: most patients should be taking magnesium

Magnesium plays a key role in hundreds of physiological processes and is very commonly depleted to suboptimal levels by common stresses. A paper recently published in the Journal of Neural Transmission is a good reminder that magnesium supplementation should be considered for all patients suffering from migraine. The authors state:

"Magnesium, the second most abundant intracellular cation, is essential in many intracellular processes and appears to play an important role in migraine pathogenesis."

It's important for clinicians to be aware that tissue magnesium status is not reliably reflected by serum, or even red blood cell membrane, levels...*

"Routine blood tests do not reflect true body magnesium stores since <2 % is in the measurable, extracellular space, 67 % is in the bone and 31 % is located intracellularly."

The depredations of magnesium insufficiency are legion...

"Lack of magnesium may promote cortical spreading depression, hyperaggregation of platelets, affect serotonin receptor function, and influence synthesis and release of a variety of neurotransmitters."

Suboptimal levels of magnesium are ubiquitous, and circumstances that deplete magnesium resulting in the need to increase supplementation are common. They include alcohol consumption and long haul air travel. Moreover...

"Migraine sufferers may develop magnesium deficiency due to genetic inability to absorb magnesium, inherited renal magnesium wasting, excretion of excessive amounts of magnesium due to stress, low nutritional intake, and several other reasons."

Regarding migraine specifically:

"There is strong evidence that magnesium deficiency is much more prevalent in migraine sufferers than in healthy controls. Double-blind, placebo-controlled trials have produced mixed results, most likely because both magnesium deficient and non-deficient patients were included in these trials. This is akin to giving cyanocobalamine in a blinded fashion to a group of people with peripheral neuropathy without regard to their cyanocobalamine levels. Both oral and intravenous magnesium are widely available, extremely safe, very inexpensive and for patients who are magnesium deficient can be highly effective."

The authors' point about the critical flaws in many, if not most, studies on nutrient supplementation should be borne in mind by practitioners and the public alike: treating with an agent like magnesium or cyanocobalamine (a form of vitamin B12) will not yield a beneficial result if the subject is not deficient to begin with. The authors conclude:

"Considering these features of magnesium, the fact that magnesium deficiency may be present in up to half of migraine patients, and that routine blood tests are not indicative of magnesium status, empiric treatment with at least oral magnesium is warranted in all migraine sufferers."

* Clinician's note: The Exa Test® does provide reliable tissue levels of magnesium and other minerals analytical scanning electron microscopy (ASEM) and elemental X-ray analysis (fluorescence) performed on easily obtained buccal epithelial cells.